ABSTRACT
The fibula osteoseptocutaneous flap has undergone multiple refinements since its first
description in oromandibular reconstruction. There is now a better understanding of
the blood supply to the skin of the lateral aspect of the leg. Multiple free skin
paddles can be harvested freestyle from the lateral aspect of the leg. The size of
the flaps that can be harvested has not been clearly defined. A case report of a complex
oromandibular reconstruction following a shotgun injury to the face demonstrates a
way of maximizing the skin harvest. An osteoseptocutaneous fibula flap was used for
the replacement of the mandible and the internal lining of the oral cavity. A larger
lateral leg flap based on a musculocutaneous perforator of the peroneal artery was
used for the external and full-thickness lower-lip defect. The latter flap by definition
is a peroneal artery perforator flap, which to the best of my knowledge is terminology
that has not been used in the English literature. The main purpose of this article
is to review the blood supply of the lateral leg and how this can be utilized to reach
the goals of a complex oromandibular and total lower-lip reconstruction.
KEYWORDS
Osteoseptocutaneous fibula flap - musculocutaneous perforators - peroneal artery -
perforator flap
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Mahendra DayaF.C.S.(SA) M.B.Ch.B.(Natal)
Department of Plastic and Reconstructive Surgery, Inkosi Albert Luthuli Central Hospital
Ward D2 East, Private bag X03, Mayville 4058, South Africa
Email: dayam@iafrica.com
